Learning Ladder Application for Childcare Services

Learning Ladder Application for Childcare Services
Non-Refundable Application Fee Equal to 1st Week's Tuition Required for Wait List Placement
Learning Ladder Wait List Policy & Enrollment Procedure

Wait List Policy:

When there are no positions currently available, you will be placed on our wait list. Placement on our wait list does not guarantee that a spot will be available on your requested start date.

Once an enrollment opportunity becomes available, you will have 3 business days to accept.

Enrollment Procedure:

After accepting a position, you will receive your child’s enrollment paperwork approx. 2-4 weeks before your scheduled start date. Paperwork must be returned and a family orientation completed at least 1 week before your child’s first day.
Tour Date

MonthDayYear
Leave blank if you have not yet toured
Child Information
Child’s Name*
Gender

MaleFemale
Birth / Due Date*

MonthDayYear
Date
Requested Start Date*

MonthDayYear
Age at Enrollment*
Schedule

MondayTuesdayWednesdayThursdayFriday
Grade (School Age Children)
School Year / Summer Care (School Age Children)

After SchoolSummer
Primary Residence*

Both ParentsMotherFatherOther
Parent Information
Parent / Guardian*
Relation to Child*
Mother, Father, Etc.
Home Address*
City*
Zip*
Cell Phone Number*
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Email*
example@example.com
Parent / Guardian (2)
Relation to Child
Home Address
City
Zip
Cell Phone Number
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Email
example@example.com
Has your child been enrolled in a childcare center or in home provider?*

YESNO
List previous providers
Does your child have any known food allergies or dietary restrictions?*

YESNO
Food allergies/dietary restrictions
Has your child ever been diagnosed with any medical conditions?*

YESNO
List any medical conditions
Does your child currently take any medications that will be administered at Learning Ladder?*

YESNO
List any medications
Has your child been diagnosed with any emotional or behavioral conditions?*

YESNO
List any emotional or behavioral conditions
Does your child have any other special needs?*

YESNO
List any special needs
Are there any court ordered custody arrangements?*

YESNO
Will you be receiving tuition assistance through WI Shares or another program?*

YESNO
How did you hear about us, or who where you referred by?
I hereby acknowledge that all information provided is complete and accurate to the best of my knowledge. I understand and agree to Learning Ladder’s wait list policy, reservation policy and enrollment procedure. I will notify Learning Ladder in writing to any changes of information.
Parent Name*
Date*

MonthDayYear
Should be Empty:

Learning Ladder Application for Childcare Services

Child Information

Parent Information